Textbook of Primary Care Dermatology

Acknowledgements
Contents
About the Editors
Part I: Overview
	1: Dermatology in Primary Care
		1.1	 Introduction
		1.2	 The Patient’s Perspective
		1.3	 Websites and Apps
		1.4	 Patient Information Leaflets
		1.5	 The GP Perspective
		1.6	 Primary Care Dermatology
		References
	2: History Taking and Examination
		2.1	 Introduction
		2.2	 History Taking
		2.3	 Physical Examination
		2.4	 Conclusion
		References
	3: Investigations and Treatment in Primary Care Dermatology
		3.1	 Introduction
		3.2	 Investigations
		3.3	 Treatment Approach
		3.4	 Conclusion
		References
	4: Structure and Function of the Skin
		4.1	 Introduction
		4.2	 Structure and Function of the Skin
		4.3	 Hair and Nails
		4.4	 Function of the Skin
		4.5	 Conclusion
		Reference
	5: Terminology in Dermatology
		5.1	 Introduction
		5.2	 Descriptive Terms [1]
		5.3	 Colour
		5.4	 Shape or Configuration of Lesions
		5.5	 Texture or Morphology of Skin Lesion and Rashes
		5.6	 Feel, Form or Structure of a Lesion
		5.7	 The Distribution of a Rash
		5.8	 Secondary Skin Changes
		5.9	 Nail Changes
		5.10	 Conclusion
		Reference
	6: Teledermatology
		6.1	 Introduction
		6.2	 What Can Be Sent? What Should Not Be Sent?
			6.2.1	 Types of TD
		6.3	 Delivery Modalities
		6.4	 Settings
		6.5	 A Good Photograph
		6.6	 Actors
		6.7	 Patient Empowerment
		6.8	 Conclusion
		References
Part II: Adnexal Disease
	7: A Stepwise Approach to the Management of Acne in Primary Care
		7.1	 Introduction
		7.2	 Clinical Features and Diagnosis
		7.3	 Differential Diagnosis
		7.4	 Pathophysiology
		7.5	 Treatment
		7.6	 Topical Treatments
		7.7	 Systemic Treatments
		7.8	 Acne in Women
		7.9	 Other Treatments
		7.10	 Maintenance Treatment
		7.11	 Acne Scars
		7.12	 Rare Variants of Acne
		7.13	 Conclusion
		References
	8: Oral Isotretinoin for Severe Acne
		8.1	 Introduction
		8.2	 Mode of Action
		8.3	 Side Effects
		8.4	 Monitoring
		8.5	 Dosage
		8.6	 Outcome
		8.7	 Conclusion
		References
	9: Polycystic Ovarian Syndrome (PCOS)
		9.1	 Introduction
		9.2	 Clinical Features and Diagnosis
		9.3	 Differential Diagnosis
		9.4	 Pathophysiology
		9.5	 Treatment
		9.6	 Conclusion
		References
	10: Rosacea
		10.1	 Introduction
		10.2	 Clinical Features and Diagnosis
		10.3	 Differential Diagnosis
		10.4	 Pathophysiology
		10.5	 Topical Treatments
		10.6	 Systemic Treatments
		10.7	 Conclusion
		Reference
	11: Hidradenitis Suppurativa
		11.1	 Introduction
		11.2	 Clinical Features and Diagnosis
		11.3	 Differential Diagnosis
		11.4	 Pathophysiology
		11.5	 Treatment
		11.6	 Conclusion
		11.7	 Useful Information for Patients Is Available from the Following Sites
		References
	12: Hyperhidrosis (Excessive Sweating)
		12.1	 Introduction
		12.2	 Clinical Features and Diagnosis
		12.3	 Differential Diagnosis
		12.4	 Pathophysiology
		12.5	 Treatment
		12.6	 Conclusion
		References
Part III: Papulosquamous and Eczematous Dermatoses
	13: Atopic Eczema in Children
		13.1	 Introduction
		13.2	 Clinical Features and Diagnosis
		13.3	 Differential Diagnosis (Table 13.2)
		13.4	 Pathophysiology
		13.5	 Treatment
		13.6	 Skin Infection
		13.7	 Moisturisers
		13.8	 Avoiding Irritants
		13.9	 Stepwise Approach to Atopic Eczema (Tables 13.3 and 13.4)
		13.10	 Topical Steroids (TS)
		13.11	 Topical Calcineurin Inhibitors (TCI)
		13.12	 Clothing
		13.13	 Antihistamines
		13.14	 Allergies
		13.15	 Systemic Treatment
		13.16	 Newer Biologic Agents for Severe AE
		13.17	 Conclusion
		References
	14: Management of Eczema/Dermatitis in Adults
		14.1	 Introduction
		14.2	 Clinical Features and Diagnosis
		14.3	 Differential Diagnosis
		14.4	 Pathophysiology
		14.5	 Treatment
		14.6	 Emollients
		14.7	 Soap Substitutes
		14.8	 Topical Steroids
		14.9	 Anti-histamines
		14.10	 Topical Calcineurin Inhibitors
		14.11	 Antibacterials
		14.12	 Habit Reversal
		14.13	 Systemic Treatments
		14.14	 Conclusion
		References
	15: Management of Psoriasis in Primary Care
		15.1	 Introduction
		15.2	 Clinical Features and Diagnosis
		15.3	 Differential Diagnosis
		15.4	 Pathophysiology
		15.5	 Topical Treatments
		15.6	 Systemic treatments
		15.7	 Conclusion
		References
	16: Seborrhoeic Dermatitis (SD)
		16.1	 Introduction
		16.2	 Clinical Features and Diagnosis
			16.2.1	 Infantile Seborrhoeic Dermatitis
			16.2.2	 Adult Seborrhoeic Dermatitis
		16.3	 Differential Diagnosis
		16.4	 Pathophysiology
		16.5	 Treatment of adult SD
		16.6	 Conclusion
		References
	17: The Red Face
		17.1	 Introduction
		17.2	 Telangiectasia (Broken or Thread Veins)
		17.3	 Flushing/Blushing
		17.4	 Rosacea
		17.5	 Seborrhoeic Dermatitis (SD) and Psoriasis
		17.6	 Steroid Damage
		17.7	 Cellulitis and Erysipelas
		17.8	 Lupus Erythematosus
		17.9	 Eczema/Dermatitis
		17.10	 Keratosis Pilaris
		17.11	 Sunburn and Photosensitive Rashes on Face
		17.12	 Dermatomyositis
		17.13	 Conclusion
		References
	18: Papulo-Pustular Rashes on the Face
		18.1	 Introduction
		18.2	 Rosacea
		18.3	 Perioral Dermatitis (Periorificial Dermatitis)
		18.4	 Steroid Rosacea
		18.5	 Folliculitis
		18.6	 Gram Negative Folliculitis
		18.7	 Pseudofolliculitis Barbae (Razor Bumps, Shaving Rash)
		18.8	 Tinea Barbae
		18.9	 Drug Induced Acneiform Eruptions
		18.10	 Pyoderma Faciale
		18.11	 Conclusions
	19: Lichen Planus (LP)
		19.1	 Introduction
		19.2	 Clinical Features and Diagnosis
		19.3	 Differential Diagnosis
		19.4	 Pathophysiology
		19.5	 Treatment
		19.6	 Conclusion
		References
Part IV: Urticaria, Erythrema and Vesiculobullous Disease
	20: Urticaria
		20.1	 Introduction
		20.2	 Clinical Features and Diagnosis
		20.3	 Differential Diagnosis
		20.4	 Pathophysiology
		20.5	 Treatment
		20.6	 Conclusion
		References
	21: Allergic Skin Disorders
		21.1	 Introduction
		21.2	 Urticaria
		21.3	 Eczema/Dermatitis
		21.4	 Anaphalyxis
		21.5	 Fixed Drug Eruptions
		21.6	 Latex Allergy
		21.7	 Allergy Testing
		21.8	 Conclusion
		References
	22: Generalised Rashes in Adults
		22.1	 Introduction
		22.2	 Clinical Features and Diagnosis
		22.3	 Differential Diagnosis
		22.4	 Investigations
		22.5	 Generalised, Scaly, Non Itchy or Mildly Itch Rashes
			22.5.1	 Pityriasis Rosacea
			22.5.2	 Pityriasis Versicolour (Tinea Versicolour)
			22.5.3	 Seborrhoeic Dermatitis
			22.5.4	 Subacute Lupus Erythematosus
			22.5.5	 Drug Eruptions
			22.5.6	 Ichthyosis
			22.5.7	 Tinea Corporis
			22.5.8	 Secondary Syphilis
		22.6	 Generalised, Scaly, Itchy Rashes
			22.6.1	 Discoid Eczema
			22.6.2	 Dermatitis Herpetiformis
			22.6.3	 Erythroderma
			22.6.4	 Pruritic Papular Eruption of HIV
			22.6.5	 Nodular Prurigo
		22.7	 Generalised, Non Scaly Rashes With Little Or No Itch
			22.7.1	 Generalised Folliculitis
			22.7.2	 Urticarial Vasculitis
			22.7.3	 Erythrema Multiforme
		22.8	 Generalised, Non Scaly, Very Itchy Rashes
		22.9	 Conclusion
		References
	23: Blistering Eruptions
		23.1	 Introduction
		23.2	 Common Benign Blistering Disorders
		23.3	 Common Skin Disorders That Occasionally Blister
		23.4	 Rare Primary Blistering Eruptions
		23.5	 Conclusion
		References
	24: The Ageing Skin
		24.1	 Introduction
		24.2	 Photoageing
		24.3	 Senile Purpura (Bateman Purpura or Actinic Purpura)
		24.4	 Seborrhoeic Keratosis
		24.5	 Cherry Angioma (Campbell de Morgan Spots)
		24.6	 Generalised Pruritus
		24.7	 Cutaneous Adverse Drug Reactions
		24.8	 Bed Sores (Pressure Sores) or Decubitus Ulcers
		24.9	 Other Common Skin Dermatosis in the Elderly
		24.10	 Conclusion
	25: Skin Diseases in Pregnancy
		25.1	 Introduction
		25.2	 Skin Changes During Pregnancy
		25.3	 Specific Dermatosis of Pregnancy
			25.3.1	 Atopic Eruption of Pregnancy
			25.3.2	 Polymorphic Eruption of Pregnancy
			25.3.3	 Intrahepatic Cholestasis of Pregnancy (ICP)
			25.3.4	 Pemphigoid Gestationis (PG)
		25.4	 Febrile Rashes
		25.5	 Sexually Transmitted Diseases (STD)
		25.6	 Conclusion
		References
Part V: Paediatric Dermatology
	26: Paediatric Dermatology
		26.1	 Introduction
		26.2	 Neonatal Milia
		26.3	 Napkin Dermatitis
		26.4	 Infantile Seborrhoeic Dermatitis
		26.5	 Infantile Psoriasis
		26.6	 Infantile Acne
		26.7	 Keratosis Pilaris
		26.8	 Impetigo
		26.9	 Tinea Capitis (Scalp Ringworm)
		26.10	 Scabies in Babies
		26.11	 Conclusion
		References
	27: Exanthems and Infectious Rashes in Childhood
		27.1	 Introduction
		27.2	 Chickenpox (Varicella)
		27.3	 Measles
		27.4	 Rubella
		27.5	 Roseola Infantum
		27.6	 Fifth Disease (Slapped Cheek Syndrome)
		27.7	 Kawasaki Disease
		27.8	 Gianotti-Crosti Syndrome
		27.9	 Scarlet Fever
		27.10	 Infectious Mononucleosis (Glandular Fever)
		27.11	 Hand, Foot and Mouth Disease
		27.12	 Meningococcal Disease
		27.13	 Staphylococcal Scalded Skin Syndrome (SSSS)
		27.14	 Conclusion
		References
	28: Genodermatosis: Inherited Skin Diseases
		28.1	 Introduction
		28.2	 Down Syndrome (Trisomy 21)
		28.3	 Neurofibromatosis
			28.3.1	 Neurofibromatosis Type 1 (von-Recklinghausen’s = NF1)
			28.3.2	 Neurofibromatosis Type 2 (Bilateral Acoustic Neurofibromatosis)
		28.4	 Tuberous Sclerosis
		28.5	 Ehlers-Danlos Syndrome
		28.6	 Darier’s Disease
		28.7	 Albinism
		28.8	 Conclusion
	29: Congenital Nevi, Melanocytic Naevi (Moles) and Vascular Tumors in Newborns and Children
		29.1	 Introduction
		29.2	 Congenital Vascular Lesions
		29.3	 Congenital Melanocytic Nevi
		29.4	 Acquired Melanocytic Nevi
		29.5	 Conclusion
Part VI: Infections, Infestations and Bites
	30: Common Bacterial Skin Infections in General Practice
		30.1	 Introduction
		30.2	 Bites
		30.3	 Impetigo
		30.4	 Folliculitis
		30.5	 Boils (Furuncles or Carbuncles)
		30.6	 Secondary Infection of Eczema
		30.7	 Methicillin-Resistant Staphylococcus Aureus (MRSA)
		30.8	 Leg Ulcers
		30.9	 Streptococci Infections
			30.9.1	 Erysipelas
			30.9.2	 Cellulitis
		30.10	 Conclusion
	31: Fungal and Yeast Infection of Skin, Hair and Nails
		31.1	 Introduction
		31.2	 Ringworm
		31.3	 Tinea Pedis
		31.4	 Tinea Manuum
		31.5	 Tinea Cruris
		31.6	 Tinea Capitis
		31.7	 Tinea Unguium (Onychomycosis)
		31.8	 Tinea (Pityriasis) Versicolor
		31.9	 Conclusion
		References
	32: Cutaneous Viral Skin Infections
		32.1	 Introduction
		32.2	 Herpex Simplex
		32.3	 Genital Herpes
		32.4	 Erythema Multiforme
		32.5	 Varicella Zoster
		32.6	 Shingles (Herpes Zoster)
		32.7	 Post-Herpetic Neuralgia
		32.8	 HIV
		32.9	 Herpangina
		32.10	 Orf
		32.11	 Warts
		32.12	 Molluscum Contagiosum
		32.13	 Conclusion
		References
	33: COVID-19 and the Skin
		33.1	 Introduction
		33.2	 Skin Manifestations of COVID-19
		33.3	 Hand Eczema/Dermatitis
		33.4	 Immunosuppressants and COVID-19
		33.5	 Teledermatology
		33.6	 Dermoscopy
		33.7	 Conclusions
		References
	34: Management of Warts in General Practice
		34.1	 Introduction
		34.2	 Clinical Features and Diagnosis
		34.3	 Differential Diagnosis
		34.4	 Pathophysiology
		34.5	 Treatment
		34.6	 Ano-Genital Warts
		34.7	 Vaccination
		34.8	 Conclusion
		References
	35: Bugs and Bites
		35.1	 Introduction
		35.2	 Scabies (Sarcoptes scabiei var. hominis)
		35.3	 Head Lice (Pediculus Humanus Capitis)
		35.4	 Pubic Lice (Crabs)
		35.5	 Papular Urticaria
		35.6	 Bed Bugs (Cimex lectularius)
		35.7	 Tick Bites and Lyme Disease
		35.8	 Conclusion
		References
Part VII: Regional Dermatology
	36: Regional Dermatology
		36.1	 Introduction
		36.2	 Diagnosis and Clinical Features
		36.3	 Lesions and Rashes on the Head and Neck
		36.4	 Scalp Rashes and Lesions
			36.4.1 The Hair Bearing Scalp
			36.4.2 Scalp Rashes and Lesions on the Non-hairy Areas of the Scalp
		36.5	 Scalp Lesions
		36.6	 Beard Rashes
		36.7	 Forehead and Cheek Lesions and Rashes
		36.8	 Rashes and Lesions on the Ear
		36.9	 Ulcers, Blisters and Nodules on the Ears
		36.10	 Rashes and Lesions on the Eyelids and Inner Canthus
		36.11	 Nasal Lesion and Rashes
		36.12	 Rashes and Lesions on the Lips and in the Mouth
		36.13	 Ulcers and Nodules on the Lips and in the Mouth
		36.14	 Neck Rashes and Lesions
		36.15	 Rashes and Lesions on the Trunk
		36.16	 Flexural Rashes
		36.17	 Hand Rashes and Lesions
		36.18	 Rashes and Lesions on the Feet
		36.19	 Genital and Perianal Rashes and Lesions
			36.19.1 Female Genital Rashes, Ulcers and Lesions
			36.19.2 Ulcerating and Nodular Lesions in the Vulva
		36.20	 Male Genital Rashes and Lesions
			36.20.1 Rahes on the Penis and Scrotum
			36.20.2 Lesions on the Penis and Scrotum
			36.20.3 Genital Ulceration in Men
		36.21	 Perianal Itch, Rashes and Lesions
		36.22	 Lower Leg Rashes, Lesions, Ulcers and Blisters
			36.22.1 Ulcers and Blisters on the Pretibial Area
			36.22.2 Lesions on the Lower Legs
		36.23	 Conclusion
		References
	37: Leg Ulcers: A Treatment Programme
		37.1	 Introduction
		37.2	 Clinical Features and Diagnosis
		37.3	 Differential Diagnosis
		37.4	 Pathophysiology
		37.5	 Treatment
		37.6	 Wound Care
		37.7	 Compression Bandaging
		37.8	 Compression Stockings (Hosiery)
		37.9	 Conclusion
		References
	38: Wound Care
		38.1	 Introduction
		38.2	 Tissue
			38.2.1	 Post-operative Wound Dressings
			38.2.2	 Epithelializing Wounds
			38.2.3	 Over Granulating Wounds
			38.2.4	 Malodours Wounds
			38.2.5	 Yellow, Sloughy Wounds
		38.3	 Infections
			38.3.1	 Wound Dressings for Infected Wounds
		38.4	 Moisture
			38.4.1	 Heavily Exudating or Bleeding Wounds
			38.4.2	 Dry, Black, Necrotic, Leathery Wounds
		38.5	 Edges
		38.6	 Surrounding Skin
		38.7	 Negative Pressure Wound Therapy
		38.8	 Conclusion
		References
	39: The Red Leg
		39.1	 Introduction
		39.2	 Itchy Red Leg
		39.3	 Red Leg with Little or No Itch
		39.4	 Painful Red Leg
		39.5	 Conclusion
Part VIII: Hair and Nail Problems
	40: Hair Loss and Hair Growth
		40.1	 Introduction
		40.2	 Patterned, Non Scarring Alopecia
		40.3	 Patchy Non Scarring Alopecia
		40.4	 Diffuse Non Scarring Alopecia Without Scale
		40.5	 Diffuse, Non Scarring Alopecia with Scale
		40.6	 Scarring Alopecia (Cicatricial Alopecia)
		40.7	 Hirsutism
		40.8	 Conclusion
		References
	41: Nail Problems in General Practice
		41.1	 Introduction
		41.2	 Local Factors Affecting the Nail
		41.3	 Nail Changes Associated with Common Dermatoses
		41.4	 The Nail in Systemic Disease
		41.5	 Conclusion
		References
		Part IX: Lesion Recognition
	42: Lesion Recognition
		42.1	 Introduction
		42.2	 Benign versus Malignant Skin Lesions
		42.3	 Dermoscopy
		42.4	 Clinical Examination of Skin Lesions
		42.5	 Conclusion
		References
	43: Pigmented Lesions
		43.1	 Introduction
			43.1.1	 Pigmented Macular (Flat) Lesions
			43.1.2	 Pigmented Ulcerated Lesions
			43.1.3	 Pigmented Nodular (Raised Up) Lesions
			43.1.4	 Pigmented, Scaly/Warty Nodules
			43.1.5	 Pigmented, Nodular, Smooth, Dome Shaped Lesions
			43.1.6	 Pigmented, Fleshy, Ulcerated, Nodule
		43.2	 Conclusion
		References
	44: Non-pigmented Lesions
		44.1	 Introduction
		44.2	 Non-pigmented Macular Lesions
		44.3	 Non-Pigmented Ulcerating Lesions
		44.4	 Non-Pigmented Nodular Lesions
			44.4.1	 Non-Pigmented Scaly/Warty Nodules
			44.4.2	 Non-Pigmented Fleshy Ulcerating Nodules
			44.4.3	 Non-Pigmented Smooth Dome Shaped Nodules
			44.4.4	 Red, Smooth, Dome Shapes Nodules
			44.4.5	 Small, Discrete, Smooth, Dome-Shaped, Non-pigmented Nodules
			44.4.6	 Large (>5 mm), Discrete, Smooth, Dome Shaped, Non-pigmented Nodules
		44.5	 Conclusion
		References
	45: Cancer and Pre-Cancer of the Skin
		45.1	 Introduction
		45.2	 Epidemiology
		45.3	 Algorithms for Skin Cancer Detection
		45.4	 Skin Biopsy
		45.5	 Actinic Keratosis (AK) (Solar Keratosis)
		45.6	 Bowen’s Disease (SCC In Situ)
		45.7	 Squamous Cell Carcinomas (SCCs)
		45.8	 Basal Cell Carcinomas (BCCs)
		45.9	 Melanoma
		45.10	 Merkel Cell Carcinoma (MCC)
		45.11	 Dermatofibrosarcoma Protruberans (DFSP)
		45.12	 Kaposi Sarcoma
		45.13	 Paget’s Disease
		45.14	 Secondary Skin Cancer
		45.15	 Conclusion
		References
	46: Dermoscopy for the General Practitioner
		46.1	 Introduction
		46.2	 The Dermatoscope
		46.3	 Melanocytic Lesions
		46.4	 Digital Photography
		46.5	 Conclusion
		References
Part X: Pigment and the Skin
	47: Disorders of Pigmentation
		47.1	 Introduction
		47.2	 Hyperpigmentation
		47.3	 Hypopigmentation
		47.4	 Conclusion
		References
	48: Skin of Colour
		48.1	 Introduction
		48.2	 Epidemiology
		48.3	 Acne in Dark Coloured Skin
		48.4	 Hyperpigmentation
		48.5	 Dermatosis Papulosa Nigra
		48.6	 HIV Disease
		48.7	 Hair and Scalp Problems in Individuals with Type 6 Skin
		48.8	 Tinea Infections
		48.9	 Keloids and Hypertropic Scars
		48.10	 Folliculitis Keloidalis Nuchae
		48.11	 Tropical Diseases in the Ethnic Population
		48.12	 Conclusion
		References
Part XI: Disorders Due to Physical Agents, Systemic Conditions and the Mind
	49: Photobiology and the Skin
		49.1	 Introduction
		49.2	 Skin Conditions that Are Usually Helped by UVL
		49.3	 Skin Conditions that May Be Aggravated by UVL
		49.4	 Primary Photodermatoses
		49.5	 Drug Induced Photosensitivity
		49.6	 Phytophotodermatitis
		49.7	 Polymorphic Light Eruption
		49.8	 Juvenile Spring Eruption
		49.9	 Chronic Actinic Dermatitis
		49.10	 Solar Urticaria
		49.11	 Actinic Prurigo
		49.12	 Hydroa Vacciniforme
		49.13	 Xeroderma Pigmentosum
		49.14	 ‘‘Fake Tan”
		49.15	 Conclusion
	50: Pruritus (Itch)
		50.1	 Introduction
		50.2	 Aetiology
		50.3	 Management
		50.4	 Drug Therapy for Chronic Itch
		50.5	 Conclusion
		References
	51: Skin in Systemic Disease
		51.1	 Introduction
		51.2	 Rheumatoid Arthritis (RA)
		51.3	 Palmar Erythrema
		51.4	 Cutaneous Signs of Anorexia Nervosa (AN)
		51.5	 Vitiligo
		51.6	 Granuloma Annulare
		51.7	 Lupus Erythematosus
			51.7.1	 Systemic Lupus Erythematosus (SLE)
			51.7.2	 Subacute Lupus Erythematosus (SLE)
			51.7.3	 Discoid Lupus Erythematosus (DLE)
		51.8	 Erythema Nodosum
		51.9	 Dermatitis Herpetiformis (DH)
		51.10	 Dermatomyositis
		51.11	 Acanthosis Nigricans
		51.12	 Neutrophilic Dermatosis
			51.12.1 Pyoderma Gangrenosum
			51.12.2 Acute Febrile Neutrophilic Dermatosis
			51.12.3 Erythema Annulare Centrifugum
		51.13	 Scleroderma
			51.13.1 Morphoea
			51.13.2 Systemic Sclerosis
		51.14	 Porphyria Cutanea Tarda (PCT)
		51.15	 Cutaneous Sarcoidosis
		51.16	 Conclusion
		References
	52: Skin Problems Associated with Diabetes
		52.1	 Introduction
		52.2	 Infections
		52.3	 Cutaneous Manifestations of Diabetic Complications
		52.4	 Skin Reactions to Diabetic Treatment
		52.5	 Skin Lesions with an Association with Diabetes
			52.5.1	 Necrobiosis Lipoidica
			52.5.2	 Granuloma Annulare
			52.5.3	 Acanthosis Nigricans
			52.5.4	 Diabetic Dermopathy (“Shin Spots”)
			52.5.5	 Diabetic Bullae
			52.5.6	 Diabetic Stiff Skin
			52.5.7	 Eruptive Xanthomas
		52.6	 Skin diseases that are more common in patients with diabetes
		52.7	 Conclusion
		References
	53: Skin and the Mind (Psychodermatology)
		53.1	 Introduction
		53.2	 Psychological Aspect of Skin Disorders
			53.2.1	 Ideas, Concerns and Expectations (I.C.E.)
		53.3	 Skin Aspect of Psychiatric Disease
			53.3.1	 Habit Biters and Pickers
			53.3.2	 Skin Picking Disorder (SPD) (“Pickers Dermatitis”)
			53.3.3	 Body Dysmorphic Disorder (BDD) (Delusional Dysmorphophobia)
			53.3.4	 Delusional Infestation (Parasitophobia)
			53.3.5	 Dermatitis Artefacta
			53.3.6	 Other psychiatric conditions with skin manifestations
		53.4	 Conclusion
		References
	54: Cutaneous Vasculitis
		54.1	 Introduction
		54.2	 Cutaneous Vasculitis
		54.3	 Henoch-Schönlein purpura (HSP, also called anaphylactoid purpura)
		54.4	 Meningococcal Septicaemia
		54.5	 Urticarial Vasculitis
		54.6	 Conclusion
		References
	55: Emergencies in Dermatology
		55.1	 Introduction
		55.2	 Dermatological Emergencies
		55.3	 Burns
		55.4	 Bites
		55.5	 Meningococcal Disease
		55.6	 Acute Generalized Pustular Psoriasis (AGPP)
		55.7	 Erythroderma
		55.8	 Erythema Multiforme and Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN)
		55.9	 Drug Rash with Eosinophilia and Systemic Symptoms Syndrome (DRESS)
		55.10	 Necrotizing Fasciitis (NF)
		55.11	 Conclusion
		References
Part XII: Surgical Therapies
	56: Local Anaesthesia for Skin Surgery
		56.1	 Introduction
		56.2	 Topical Anaesthetic
		56.3	 Local Infiltration of Anaesthesia
		56.4	 Toxicity, Anaphalylaxis and Fainting
		56.5	 Conclusion
		References
	57: Simple Skin Surgery
		57.1	 Key Points
		57.2	 What to Tell the Patient
		57.3	 Introduction
		57.4	 Instruments
		57.5	 Histology
		57.6	 Bleeding and Infection
		57.7	 Sutures
		57.8	 Punch Biopsy
		57.9	 Shave Biopsy
		57.10	 Snip Biopsy
		57.11	 Curettage
		57.12	 Conclusion
		References
	58: Cryosurgery in Primary Care
		58.1	 Introduction
		58.2	 Indications
		58.3	 Safety
		58.4	 Freeze-Thaw Cycle
		58.5	 Immunocryosurgery
		58.6	 Side Effects
		58.7	 Conclusion
		References
	59: Cryosurgery for Warts in General Practice
		59.1	 Introduction
		59.2	 Cryogen
		59.3	 Equipment
		59.4	 Patient Selection
		59.5	 Technique
		59.6	 What is a 10 second Freeze-Thaw Cycle?
		59.7	 Immunocryosurgery
		59.8	 Side Effects
		59.9	 Conclusion
		References
	60: A Practice Nurse Led Cryosurgery Clinic
		60.1	 Introduction
		60.2	 Techniques
		60.3	 Conclusion
		Reference
Part XIII: Pharmacology and the Skin
	61: Pharmacists and Skin Disease
		61.1	 Introduction
		61.2	 Diagnosis
		61.3	 Treatment of Skin Diseases
		61.4	 Health Promotion
		61.5	 Chronic Disease Management
		61.6	 Conclusion
		Reference
	62: Emollients and Moisturisers
		62.1	 What to Tell the Patient
		62.2	 Introduction
		62.3	 Ointments Versus Creams
		62.4	 Active Ingredients
		62.5	 Soap Substitutes and Bath Oils
		62.6	 Conclusion
		References
	63: Steroids in Dermatology
		63.1	 What to Tell the Patient
		63.2	 Introduction
		63.3	 Potency
		63.4	 The Fingertip Unit (FTU)
		63.5	 Topical Steroid Vehicle (Base)
		63.6	 Compliance
		63.7	 Conclusion
		Reference
	64: Topical Immunomodulators (TIMs)
		64.1	 What to Tell the Patient
		64.2	 Introduction
		64.3	 Tacrolimus (“Protopic®”) Ointment
		64.4	 Pimecrolimus (“Edilel®”) Cream
		64.5	 Conclusion
		References
Part XIV: Nurses, Patients, Courses and Websites
	65: Nursing Care of the Dermatology Patient
		65.1	 Introduction
		65.2	 Topical Therapies
		65.3	 Dermatological Surgery
		65.4	 Allergy Testing
		65.5	 Skin Cancer Screening and Treatment
		65.6	 Nurse Lead Wart Clinics
		65.7	 Professional Nursing Associations
		65.8	 Conclusion
		References
	66: Patient Information Leaflets (PIL)
		66.1	 Acne
			66.1.1	 Acne—how to treat it
			66.1.2	 Isotretinoin (“Roaccutance®”): What patients need to know
		66.2	 Consent Forms
			66.2.1	 CONSENT FORM
			66.2.2	 Photography Consent
		66.3	 Eczema/Dermatitis
			66.3.1	 Cow’s Milk (Dairy) Allergy
			66.3.2	 Hand care tips for hand eczema and dermatitis
			66.3.3	 Ketoconazole (“Nizoral®”) Shampoo
			66.3.4	 Management of Dry Sensitive Skin Conditions
			66.3.5	 Milton Baths
			66.3.6	 Tacrolimus (“Protopic®”) + pimecrolimus (Elidel®)
			66.3.7	 Topical Steroids; There safe use
			66.3.8	 Wet wraps
		66.4	 Hair Loss
			66.4.1	 Hair Loss in Men
			66.4.2	 Hair Loss in Women
		66.5	 Infections and Infestations
			66.5.1	 All about Warts
			66.5.2	 Patients instructions on detection and treatment of head lice
			66.5.3	 Treating Fungal Nail Infections with terbinafine (“Lamisil®”) Anti-fungal Tablets
			66.5.4	 Treatment of Scabies
				66.5.4.1	 Instructions for Use
		66.6	 Skin Cancer
			66.6.1	 5 Fluorouracil (“Effudix®”)
			66.6.2	 Primary Melanomas
			66.6.3	 Skin cancer screening
			66.6.4	 Skin cancer. What to look out for
			66.6.5	 Warning signs for melanoma
		66.7	 Skin Surgery
			66.7.1	 Anticoagulants and surgery-patient information
			66.7.2	 Care of your wound after surgery
			66.7.3	 Cryosurgery clinic
		66.8	 Sun Protection
			66.8.1	 Be safe in the sun
			66.8.2	 The Sun and Vitamin D
		66.9	 Miscellaneous
			66.9.1	 Advice for patients with varicose ulcers
			66.9.2	 Hyperhydrosis
			66.9.3	 Keratosis Pilaris
			66.9.4	 Methotrexate Information
			66.9.5	 Pruritis Ani
			66.9.6	 Tinea Versicolor Treatment
			66.9.7	 Top ten self-care tips for people with psoriasis
	67: Useful Websites, Courses, Bibliography and Patient Support Groups
		67.1	 General Dermatology Resources for Patients
		67.2	 Websites for Healthcare Professionals
		67.3	 Patient Information Videos
		67.4	 Courses and Diplomas
		67.5	 Textbooks
			67.5.1	 Diagnosis
			67.5.2	 Dermoscopy
			67.5.3	 Treatment
			67.5.4	 Dermatological Surgery
			67.5.5	 Cryosurgery Books
Index